Student Confirmation of
Outside Physical Activity for Make-up
Student
name ___________________________________________________________
To
make up an excused absence from Physical Education, the student must
participate in 45 min. of continuous physical activity. Use this form to
document your participation in physical activity.
If the teacher cannot reach the contact person, the student will not
receive credit for the activity.
Describe
the activity in which you participated to meet the make up requirements.
Describe
the component(s) of fitness benefited from the activity.
Time and dates you completed in the above
activity.
Date___________________
Time
started_____________
Time
concluded____________
Total
activity time____________
Identify
the contact person (adult) to verify you participated in the activity above.
Name
of contact person:
__________________________________
Position
of person (coach etc.)__________________________________
Contact
person phone # __________________________________
Best
time to call
__________________________________
Teacher
signature
__________________________________